Abstract：
OBJECTIVE: Vertebral artery (VA) injury poses a significant risk in cervical spine surgery, necessitating accurate preoperative assessment. This study aims to introduce and validate a novel approach that combines the Fast field echo that resembles a computed tomography using restricted echo spacing (FRACTURE) sequence with Time of Flight (TOF) Magnetic Resonance Angiography (MRA) for comprehensive evaluation of VA courses in the cervical spine.
METHODS: A total of eight healthy volunteers and two patients participated in this study. The FRACTURE sequence provided high-resolution bone images of the cervical spine, while TOF MRA offered non-invasive vascular imaging. Fusion images were created by merging FRACTURE and MRA modalities to simultaneously visualize cervical spine structures and VA courses. Board-certified orthopedic spine surgeons independently evaluated images to assess the visibility of anatomical characteristics of the VA course by Likert-scale.
RESULTS: The FRACTURE-MRA fusion images effectively depicted the extraosseous course of the VA at the craniovertebral junction, the intraosseous course of the VA at the craniovertebral junction, the VA entrance level to the transverse foramen, and the side-to-side asymmetry of bilateral VAs. Additionally, clinical cases demonstrated the utility of the proposed technique in identifying anomalies and guiding surgical interventions.
CONCLUSIONS: The integration of the FRACTURE sequence and TOF MRA presents a promising methodology for the precise evaluation of VA courses in the cervical spine. This approach improves preoperative planning for cervical spine surgery with detailed anatomy and is a valuable alternative to conventional methods without contrast agents.
METHODS: A total of eight healthy volunteers and two patients participated in this study. The FRACTURE sequence provided high-resolution bone images of the cervical spine, while TOF MRA offered non-invasive vascular imaging. Fusion images were created by merging FRACTURE and MRA modalities to simultaneously visualize cervical spine structures and VA courses. Board-certified orthopedic spine surgeons independently evaluated images to assess the visibility of anatomical characteristics of the VA course by Likert-scale.
RESULTS: The FRACTURE-MRA fusion images effectively depicted the extraosseous course of the VA at the craniovertebral junction, the intraosseous course of the VA at the craniovertebral junction, the VA entrance level to the transverse foramen, and the side-to-side asymmetry of bilateral VAs. Additionally, clinical cases demonstrated the utility of the proposed technique in identifying anomalies and guiding surgical interventions.
CONCLUSIONS: The integration of the FRACTURE sequence and TOF MRA presents a promising methodology for the precise evaluation of VA courses in the cervical spine. This approach improves preoperative planning for cervical spine surgery with detailed anatomy and is a valuable alternative to conventional methods without contrast agents.
摘要：
目的：椎动脉（VA）损伤在颈椎手术中构成重大风险，需要准确的术前评估。本研究旨在介绍和验证一种新颖的方法，该方法结合了使用受限回波间距（FRACTURE）序列和飞行时间（TOF）磁共振血管造影（MRA）的计算机断层扫描，以全面评估颈椎中的VA课程。
方法：共有8名健康志愿者和2名患者参加了这项研究。骨折序列提供了颈椎的高分辨率骨骼图像，而TOFMRA提供非侵入性血管成像。通过合并骨折和MRA模式来创建融合图像，以同时可视化颈椎结构和VA课程。董事会认证的骨科脊柱外科医生独立评估图像，以通过Likert量表评估VA课程的解剖特征的可见性。
结果：骨折-MRA融合图像有效地描绘了颅骨交界处VA的骨外进程，颅骨交界处VA的骨内过程，横向孔的VA入口水平，以及双边VAs的左右不对称性。此外,临床病例证明了所提出的技术在识别异常和指导手术干预方面的实用性.
结论：骨折序列和TOFMRA的整合为精确评估颈椎VA病程提供了一种有前途的方法。这种方法通过详细的解剖结构改善了颈椎手术的术前计划，是不使用造影剂的常规方法的有价值的替代方法。
方法：共有8名健康志愿者和2名患者参加了这项研究。骨折序列提供了颈椎的高分辨率骨骼图像，而TOFMRA提供非侵入性血管成像。通过合并骨折和MRA模式来创建融合图像，以同时可视化颈椎结构和VA课程。董事会认证的骨科脊柱外科医生独立评估图像，以通过Likert量表评估VA课程的解剖特征的可见性。
结果：骨折-MRA融合图像有效地描绘了颅骨交界处VA的骨外进程，颅骨交界处VA的骨内过程，横向孔的VA入口水平，以及双边VAs的左右不对称性。此外,临床病例证明了所提出的技术在识别异常和指导手术干预方面的实用性.
结论：骨折序列和TOFMRA的整合为精确评估颈椎VA病程提供了一种有前途的方法。这种方法通过详细的解剖结构改善了颈椎手术的术前计划，是不使用造影剂的常规方法的有价值的替代方法。
